不同入路腹腔镜根治性肾切除术的临床疗效评估  

Evaluation of curative effects of different approaches in laparoscopic radical nephrectomy

作　　者：王淇超[1,2] 曹敬毅[1,2] 蒋思雄[3] 孙卫兵[3] 吴刚[1,2] 王乾[1,2] 赵炎[1,2] 关升[3] 

机构地区：[1]江苏大学附属徐州医院 [2]徐州市肿瘤医院泌尿外科,江苏徐州221005 [3]大连医科大学附属第二医院泌外一科

出　　处：《临床泌尿外科杂志》2015年第8期682-684,689,共4页Journal of Clinical Urology

摘　　要：目的：评估经腹路径及经后腹腔路径行腹腔镜根治性肾切除术的临床疗效。方法：回顾性分析2008年3月-2014年6月于大连医科大学附属二院行腹腔镜肾根治性切除术的患者73例,依据手术方式不同分为经腹路径组（32例）及后腹腔路径组（41例）,比较两组患者在手术时间、术后住院时间、术中出血量及肛门排气时间等临床资料的差异。结果：经腹路径组患者肿瘤大小为（5.62±1.51）cm,大于后腹腔路径组患者的（4.41±1.78）cm,差异有统计学意义（P=0.032）;经腹路径组患者的平均手术时间为（169±53.8）min,高于后腹腔路径组的（151±47.9）min,差异有统计学意义（P=0.036）。两组在术中出血量、术后住院时间及手术并发症发生率方面相比,差异无统计学意义（P〉0.05）。结论：两种路径腹腔镜根治性肾切除术均获得良好的临床疗效,经腹路径更适用于体积较大的肿瘤。Objective： To compare the clinical value between transperitoneal and retroperitoneal approach in laparoscopic radical nephrectomy. Method.. This retrospective study was undertaken to review 73 renal tumor cases presented at the second affiliated hospital of Dalian Medical University from March 2008 to June 2014. Thirty- two patients underwent transperitoneal approach and 41 patients underwent retroperitoneal approach. Operation time, postoperative hospital stay, intraoperative blood loss, intestinal function recovery time and other clinical data were compared between two groups. Result： For transperitoneal and retroperitoneal approach, the mean diameter of tumors was （5.62±1.51） cm and （4.41±1. 78） cm （ P =0. 032）, and operation time was （169±53.8） rain and （151±47.9） min （ P =0. 036）. However, there was no statistically significant difference in intraoperative blood loss, postoperative hospital stay and the incidence of operative complication between two groups （ P〉 0.05）. Conclusion： Laparoscopic radical nephrectomy through transperitoneal or retroperitoneal approach both receive good clinical efficacy. The transperitoneal approach is more suitable for large size tumors.

关 键 词：肾肿瘤 腹腔镜根治性肾切除术 经腹路径 经后腹腔路径 

分 类 号：R737.11[医药卫生—肿瘤]